GETESA (Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente), Rene Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Ave, Barro Preto, Belo Horizonte, Minas Gerais, 30190-009, Brazil.
Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), University of Strathclyde, Glasgow, G4 0RE, UK.
BMC Med Res Methodol. 2022 Mar 27;22(1):80. doi: 10.1186/s12874-022-01568-y.
The main purposes of primary care-based pharmaceutical services (PHCPS) in Brazil are to provide free access to medicines and pharmaceutical care to patients. Several obstacles hinder achieving their goals; thus, MedMinas Project aimed to evaluate the PHCPS, the supply system, and the use of medicines. This paper reflects on our experience designing, planning, and conducting the project, describing the issues yielded in the field and lessons learned.
This work consists of a mixed-methods study conducted in Minas Gerais, Southeastern Brazil. We adopted the principles of Rapid Evaluation Methods, employing a multistage stratified sampling for the quantitative and a purposeful sampling for the qualitative components, respectively, and a documentary research. Data sources included individuals (patients and professionals), prescriptions, dispensed medicines, and policy documents collected between April and October 2019. The quantitative data described in this paper were analysed by descriptive statistics and the qualitative by Thematic Content Analysis.
A total of 26 municipalities varying from 37,784 to 409,341 inhabitants were included. The field team spent, on average, 16 days in each location. We interviewed 1019 respondents, of which 127 were professionals and 892 patients. The participation rate varied from 92 to 100%, depending on the respondent subgroup. Most interviews lasted between 45 min and one hour. Fieldwork challenges included participants' enrolment, field team, interview processes, and project budget. The participants provided positive feedback and five main themes emerged from the interview experience (self-awareness, sense of gratitude, research value, access to findings, and benefits of the research). Additionally, we collected copies of 1072 documents and 2070 pieces of data from prescriptions filled and medicines dispensed at the PCP.
We demonstrated the viability of conducting the MedMinas Project in an extensive geographic area within effective time frames that provided meaningful, high-quality data from multiple actors. The methods and lessons learned are valuable for researchers across various disciplines in similar urban settings in Brazil and other countries of low- and middle-income (LMIC).
巴西基层医疗为基础的药物服务（PHCPS）的主要目的是为患者提供免费的药物和药物护理。有几个障碍阻碍了实现这些目标，因此，MedMinas 项目旨在评估 PHCPS、供应系统和药物使用情况。本文反映了我们在设计、规划和开展该项目方面的经验，描述了在实地产生的问题和吸取的教训。
这是一项在巴西东南部米纳斯吉拉斯州进行的混合方法研究。我们采用了快速评估方法的原则，分别对定量部分采用多阶段分层抽样，对定性部分采用目的抽样，并进行文献研究。数据来源包括个人（患者和专业人员）、处方、配药和 2019 年 4 月至 10 月期间收集的政策文件。本文所描述的定量数据采用描述性统计分析，定性数据采用主题内容分析。
共纳入了 26 个从 37784 到 409341 居民的市镇。现场小组平均在每个地点花费 16 天。我们共采访了 1019 名受访者，其中 127 人是专业人员，892 人是患者。受访者的参与率根据受访者群体的不同，从 92%到 100%不等。大多数访谈持续时间在 45 分钟到一个小时之间。现场工作的挑战包括参与者的登记、现场小组、访谈过程和项目预算。参与者提供了积极的反馈，从访谈经验中出现了五个主要主题（自我意识、感激之情、研究价值、获得研究结果和研究的好处）。此外，我们还收集了在 PCP 填写的 1072 份处方和配药的 2070 份文件和数据的副本。
我们证明了在有效时间框架内，在广泛的地理区域内开展 MedMinas 项目的可行性，从多个参与者那里获得了有意义的高质量数据。该方法和经验教训对于巴西和其他中低收入国家（LMIC）类似城市环境中各学科的研究人员具有重要价值。
